Suicide
Suicide (from Latin sui caedere, to kill oneself) is the act of willfully ending one's own life. Suicide can also refer to the individual who has committed or attempted the act. Terminology Suicidal ideation Suicidal ideation is thinking about taking one’s life. The thoughts may range from a vague and unformed state to detailed and planned. Parasuicide Many suicidal people participate in suicidal activities that do not result in death. These activities fall under the designation attempted suicide or parasuicide. Those with a history of such attempts are almost 23 times more likely to eventually end their own lives than those who don't participate in such activites. Suicidal gestures and attempts Sometimes, a person will make actions resembling suicide attempts while not being fully committed, or in a deliberate attempt to have others notice. This is called a suicidal gesture (also known as a "cry for help"). Prototypical methods might be a non-lethal method of self-harm that leaves obvious signs of the attempt, or simply a lethal action at a time when the person considers it likely that he/she will be rescued or prevented from fully carrying it out. On the other hand, a person who genuinely wishes to die may fail, due to lack of knowledge about what they are doing, unwillingness to try methods that may end in permanent damage if they fail or harm others, or an unanticipated rescue, among other reasons. This is referred to as a suicidal attempt. Distinguishing between a suicidal attempt and a suicidal gesture may be difficult. Intent and motivation are not always fully discernible since so many people in a suicidal state are genuinely conflicted over whether they wish to end their lives. One approach, assuming that a sufficiently strong intent will ensure success, considers all near-suicides to be suicidal gestures. This however does not explain why so many people who fail at suicide end up with severe injuries, often permanent, which are most likely undesirable to those who are making a suicidal gesture. Another possibility is those wishing merely to make a suicidal gesture may end up accidentally killing themselves, perhaps by underestimating the lethality of the method chosen or by overestimating the possibility of external intervention by others. Suicide-like acts should generally be treated as seriously as possible because if there is an insufficiently strong reaction from loved ones from a suicidal gesture, this may motivate future, and ultimately more committed attempts. In the technical literature the use of the terms parasuicide, or deliberate self-harm (DSH) are preferred – both of these terms avoid the question of the intent of the actions. Self-harm An important difference to note is that self-harm is not a suicide attempt. There is a non-causal correlation between self-harm and suicide; individuals who suffer from depression or other mental health issues are also more likely to choose suicide. Deliberate self-harm (DSH) is far more common than suicide, and the majority of DSH participants are females aged under 35. They are usually not physically ill and while psychological factors are highly significant, they are rarely clinically ill and severe depression is uncommon. Social issues are key as DSH is most common among those living in overcrowded conditions, in conflict with their families, with disrupted childhoods and history of drinking, criminal behavior, and violence. Individuals under these stresses become anxious and depressed and then, usually in reaction to a single particular crisis, they attempt to harm themselves. The motivation may be a desire for relief from emotional pain or to communicate feelings, although the motivation will often be complex and confused. DSH may also result from an inner conflict between the desire to end life and the desire to continue living. Assessment of suicide risk Suicide note A written message left by someone who attempts or commits suicide is known as a suicide note. The practice is fairly common, occurring in approximately one out of three suicides.http://wonder.cdc.gov/wonder/prevguid/p0000164/p0000164.asp Motivations for leaving one range from seeking closure with loved ones to exacting revenge against others by blaming them for the decision. Combination of homicide and suicide Since crime just prior to suicide is often perceived as being without consequences, it is not uncommon for suicide to be linked with homicide. Motivations may range from guilt to evading punishment, insanity, and killing others as part of a suicide pact. Assisted suicide A suicidal individual who lacks the physical capacity to take their own life may enlist someone else to carry out the act on their behalf, frequently a family member or physician. This may or may not be considered a form of suicide according to different moral views of the practice, with opponents regarding it instead as akin to murder. Assisted suicide is a contentious moral and political issue in many countries. Methods In countries where firearms are readily available, many suicides involve the use of firearms. In fact, just over 55% of suicides committed in the United States in 2001 were by firearmhttp://www.preventsuicidenow.com/suicide-statistics.html. Asphyxiation methods (including hanging) and toxification (poisoning and overdose) are fairly common as well. Each comprised about 20% of suicides in the US during the same time period. Other methods of suicide include blunt force trauma (jumping from a building or bridge, or stepping in front of a train, for example), exsanguination or bloodletting (slitting one's wrist or throat), self-immolation, electrocution, car collision and intentional starvation. Epidemiology : Suicide, 1877]] According to official statistics, about a million people commit suicide annually, more than those murdered or killed in war. . As of 2001 in the USA, suicides outnumber homicides by 3 to 2 and deaths from AIDS by 2 to 1 Health and suicide Mental disorders (particularly depression and substance abuse) are associated with more than 90% of all cases of suicide. An unknown amount of suicide fatalities are misdiagnosed as consequences of severe illness. Season and suicide People commit suicide more often during spring and summer. The idea that suicide is more common during the winter holidays (including Christmas in the northern hemisphere) is a common misconception. Other reasons Causes of suicide No single factor has gained acceptance as a universal cause of suicide. However, depression is a common phenomenon amongst those who commit suicide. According to the World Health Organization's report on international male suicide rates, nine of ten of the nations with the highest male suicide rates are strongly irreligious nations with the highest levels of atheism, while countries with the lowest male suicide rates are highly religious nations with statistically insignificant levels of organic atheism. Sociologist Phil Zuckerman also published these same results concerning male suicide rates and atheism. Moreover, according to the American Psychiatric Association, "religiously unaffiliated subjects had significantly more lifetime suicide attempts and more first-degree relatives who committed suicide than subjects who endorsed a religious affiliation." Moreover, individuals with no religious affiliation had fewer moral objections to suicide than believers. Suicide and mental illness Suicide prevention and treatment Impact of suicide It is estimated that an average of six people are suicide "survivors" for each suicide that occurs in the United Stateshttp://www.suicidology.org/displaycommon.cfm?an=6. It is important to note that in the context of suicide, the word "survivors" refers to the family and friends of the person who has died by suicide; this figure therefore does not represent the total number of people who may be affected. For example, the suicide of a child may leave the school and their entire community left to make sense of the act. As with any death, family and friends of a suicide victim feel grief associated with loss. These suicide survivors are often overwhelmed with psychological trauma as well, depending on many factors associated with the event. This trauma can leave survivors feeling guilty, angry, remorseful, helpless, and confused. It can be especially difficult for survivors because many of their questions as to why the victim felt the need to take his or her own life are left unanswered. Moreover, survivors often feel that they have failed or that they should have intervened in some way. Given these complex sets of emotions associated with a loved one's suicide, survivors usually find it difficult to discuss the death with others, causing them to feel isolated from their own network of family and friends and often making them reluctant to form new relationships as well. http://www.faqs.org/faqs/suicide/info/. "Survivor groups" can offer counseling and help bring many of the issues associated with suicide out into the open. They can also help survivors reach out to their own friends and family who may be feeling similarly and thus begin the healing process. In addition, counseling services and therapy can provide invaluable support to the bereaved. Some such groups can be found online, providing a forum for discussion amongst survivors of suicide (see Support Groups for Survivors section below). As well as providing counseling for the grief-stricken, survivor groups have also attempted to change the language used to describe suicide. Believing that the term "commit" attaches criminal implications to suicide, they have pushed for alternative terms that remove this meaning including "attempting" suicide, or "died by" suicide . Views of suicide Medical Modern medicine treats suicide as a mental health issue. Overwhelming suicidal thoughts are considered a medical emergency. Medical professionals advise that people who have expressed plans to kill themselves be encouraged to seek medical attention immediately. This is especially important if the means (weapons, drugs, or other methods) are available, or if the patient has crafted a detailed plan for executing the suicide. Special consideration is given to trained personnel to look for suicidal signs in patients. Depressive people are considered a high-risk group for suicidal behavior. Suicide hotlines are widely available for people seeking help. However, the negative and often too clinical reception that many suicidal people receive after relating their feelings to health professionals (threats of institutionalization, simply increasing dosages of medication, the stigmatization of suicide as a topic of discussion, etc), often causes them to keep their suicidal thoughts to themselves. Cultural In the Warring States Period and the Edo period of Japan, samurai who disgraced their honor chose to end their own lives by harakiri (hara = stomach, kiri = cut) or seppuku, a method in which the samurai takes a sword and slices into his abdomen, causing a fatal injury. The cut is usually performed diagonally from the top corner of the samurai's writing hand, and has long been considered an honorable form of death (even when done to punish dishonor). Though obviously such a wound would be fatal, seppuku was not always technically suicide, as the samurai's assistant (the kaishaku) would stand by to cut short any suffering by quickly administering decapitation--sometimes as soon as the first tiny incision into the abdomen was made. Religious Debate over suicide Some see suicide as a legitimate matter of personal choice and a human right (colloquially known as the right to die movement), and maintain that no one should be forced to suffer against their will, particularly from conditions such as incurable disease, mental illness, and old age that have no possibility of improvement. Proponents of this view reject the belief that suicide is always irrational, arguing instead that it can be a valid, albeit drastic, last resort for those enduring major pain or trauma. This perspective is most popular in Continental Europehttp://www.time.com/time/europe/magazine/article/0,13005,901050404-1042414,00.html, where euthanasia and other such topics are commonly discussed in parliament, although it has a good deal of support in the United States as well. A narrower segment of this group considers suicide a sacrosanct right for anyone (even a young and healthy person) who believes they have rationally and conscientiously come to the decision to end their own lives. Notable supporters of this school of thought include German pessimist philosopher Arthur Schopenhauerhttp://comp.uark.edu/~mpianal/schopenhauer.htm. Adherents of this view often advocate the abrogation of statutes that restrict the liberties of people known to be suicidal, e.g. laws permitting their involuntary commitment to mental hospitals. Critics may argue that suicidal impulses are inherently products of mental illness and therefore not a valid exercise of rational self-interest, and that because of the gravity and irreversibility of the decision to take one's life it is more prudent for society to err on the side of caution and protect suicidal individuals from themselves. Suicide as a crime In some jurisdictions, an act or failed act of suicide is considered to be a crime. Some places consider failure to be attempted murder, with the victim being oneself, and will prosecute such offenders for attempted murder. More commonly, a surviving party member who assisted in the suicide attempt will face criminal charges. In Brazil, suicide is not a crime, but it is the instigation or help to commit it. If the help is directed to a minor, the crime is homicide. In Italy and Canada, instigating another to commit suicide is also a criminal offence. See also *List of prescription drugs associated with increased risk of suicide References See also * American Foundation for Suicide Prevention * Assisted suicide * Cult suicide * Death and dying * Dutiful suicide * National Suicide Prevention Lifeline * Psychological autopsy * Samaritans (charity) * Seasonal effects on suicide rates * Self-harm * Seppuku (Harakiri) * Suicidal ideation * Suicide Act 1961 * Suicide methods * Suicider * Suicide attack * Suicide (book) * Suicide Note * Suicidology * List of countries by suicide rate References & Bibliography Key texts Books *Hawton K, van Heeringen K, eds. International Handbook of Suicide and Attempted Suicide. Chichester: Wiley, 2000:405–420. Papers *Williams JMG, Pollock LR. The psychology of suicidal behaviour. In: Hawton K, van Heeringen K, eds. International handbook of suicide and attempted suicide. Chichester: Wiley, 2000:79–93. Additional material Books Papers *Google Scholar Further reading * Bongar, B. The Suicidal Patient: Clinical and Legal Standards of Care. Washington, D.C.: APA. 2002. ISBN 1-55798-761-0 * * Stone, Geo. Suicide and Attempted Suicide: Methods and Consequences. New York: Carroll & Graf, 2001. ISBN 0-7867-0940-5 Humphry, Derek. Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying. Dell. 1997. * Maguire, Maureen, Uncomfortably Numb. A Prison Requiem. Luath Press 2001. ISBN 1-84282-001-X (A factual documentation of suicide in prison) *Stottlemire, JD, You Me and Apollo: Hope Beyond Bipolar Disorder. Chipmunka Publishing 2008. ISBN 978-1847474544. (Examines the relationship between suicide and bipolar disorder) External links Support groups * Samaritans (UK) - 24-hour support help, United Kingdom * Befrienders Worldwide Worldwide Suicide Prevention help * TakeThisLife.com - a community offering support and hope to people with depression or suicidal thoughts * #alt.suicide.bus.stop (ASBS) - a support group for the suicidal, by the suicidal * Befrienders Worldwide - information about suicide for most countries * The Suicide Forum - a support forum for people in crisis * Support groups for survivors * American Association of Suicidology - Referrals to local self help groups for survivors of suicide across the United States * Heartbeat - Mutual support for those who have lost loved ones to suicide * SOLES - Survivors of Law Enforcement Suicide * International Friends and Families of Suicide - Online support for survivors internationally * Parents of Suicide - Support via chatrooms and email for those who have lost sons or daughters to suicide Suicide prevention * Kristin Brooks Hope Center * Youth America Hotline * Preventing Suicide The National Journal * resources for graduate students who are depressed and or suicidal * American Foundation for Suicide Prevention * metanoia.org/suicide - suicide prevention page *"Understanding and Helping the Suicidal Person" - information on suicide prevention * The Fred Fund : suicide support, resources, online stories, memorials and interaction * TeenSuicide.us - teenage suicide prevention information * Choose Life - suicide prevention in Scotland * The Debate: a pro-choice FAQ * Teenage Suicide: Identification, Intervention and Prevention - discussion of teenage suicide prevention * Suicide and the Exceptional Child - discussion of suicide prevention in children * Suicide and Sudden Loss: Crisis Management in the Schools - discussion of suicide prevention in schools Other links * "Suicide as a Moral Alternative" - discussion on the morality of suicide, including arguments for and against * "Suicide" in the Stanford Encyclopedia of Philosophy * cbel.com/suicide/ - directory of information on suicide * American Association of Suicidology - statistics and general information * Suicide & Euthanasia - a Biblical Perspective - discussion of suicide from a biblical perspective * "The Murder of Oneself" - ethical and legal considerations in suicide and its prevention * "Lithuania's Suicide Epidemic" - article on the high suicide rates of Lithuania * "Suicide rates per 100 000 by country, year and sex" by the World Health Organization * Highest suicide rates in the world - list of the ten countries with the most suicides per 100,000 inhabitants per year * Grief and Bereavement Resources * Suicide Promotion (Internet) - United Kingdom Parliamentary debate - debate by politicians on suicide, 25 January 2005 * Online Education on Suicide Prevention for Professionals - list of courses for medical professionals Category:Self destructive behavior Category:Causes of death Category:Sociology * Category:Psychological conditions